• Journal of Chest Surgery
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• v.28 no.5
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• pp.495-498
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• 1995

Pulmonary arteriovenous fistula can be either congenital or acquired. The vast majority are congenital, and about 60% have been associated with hereditary hemorrhagic telangiectasia [Rendu-Osler-Weber disease . Secondary or acquired pulmonary arteriovenous fistula occurs with trauma, schistosomiasis, long-standing hepatic cirrhosis, metastatic carcinoma, and actinomycosis. Pulmonary hemorrhage secondary to acquired pulmonary arteriovenous fistula is a rare event associated with mortality. We have experienced 64 year-old female patient with the hemoptysis secondary to acquired pulmonary arteriovenous fistula due to the infection of pulmonary parasite. The chest PA and CT scan was showed calcified nodule to the distal portion of lateral segmental bronchus of RML. The bronchial angiogram was demonstrated slightly hypertrophied bronchial artery supplying RML bronchus and the presence of hypervascularization around the calcified nodule, rapid A-V shunting is noted by fluoroscopy. The patient was successfully treated by the right middle lobectomy.

• Journal of Chest Surgery
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• v.27 no.1
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• pp.52-56
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• 1994

This is case report of total anomalous pulmonary venous return with atrial septal defect which were corrected surgically by intracardiac procedure under total cardiopulmonary bypass.Two patients were supracardiac type,cardiac and mixed type was each one.The mixed type was three years old female patient.She was diagnosed as atrial septal defect with partial anomalous pulmonary venous return[right pulmonary vein drains into superior vena cava and right atrium] and corrected as usual.After operation,she underwent exertional dyspnea and frequent tachycardia.Chest x-ray film showed pulmonary congestion.Follow up cardiac cineangiogram revealed that left pulmonary vein also anomalously drained into left innominate vein through vertical vein.Through left thoracotomy,anastomosis was successfully carried between left atrium and vertical vein without cardiopulmonary bypass and there was no sign of pulmonary artery obstruction for two years follow up.The other three patient were corrected successfully without complication and got good result.

• Tuberculosis and Respiratory Diseases
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• v.45 no.4
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• pp.896-901
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• 1998

Pulmonary arteriovenous malformation(PAVM) is an uncommon congenital anomaly. As pulmonary arteriovenous malformation is a direct communication between the branches of pulmonary artery and vein which originated from the malformation of capillary development, major disturbances in gas exchange can result. This malformation results in the several symptoms such as dyspnea, hemopyssis, cyanosis, and severe neurologic complaints. However, the most of patients are usually asymptomatic. Selective pulmonary angiography is well known the helpful diagnostic method. Recently, therapeutic embolization has been advocated as the treatment of choice for pulmonary arteriovenous malformations. We report a case of multiple pulmonary arteriovenous malformation, which was detected on the simple chest X-ray and successfully treated with coil embolization in a 19-year-old asymptomatic woman.

• Tuberculosis and Respiratory Diseases
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• v.43 no.4
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• pp.590-599
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• 1996

Background : Bronchial artery embolization has been established as an effective means to control hemoptysis, especially in patients with decreased pulmonary function and those with advanced chronic obstructive pulmonary disease. We evaluated the effect of arterial embolization in immediate control of massive hemoptysis and investigated the clinical and angiographic characteristics and the course of patients with reccurrent hemoptysis after initial succeseful embolization. Another purpose of this study was to find predictive that cause rebleeding after bronchial artery embolization. Method : We reviewed 47 cases that underwent bronchial artery embolization for the management of massive hemoptysis, retrospectively. We analyzed angiographic findings in all cases before bronchial artery embolization and also reviewed the angiographic findings of patients that underwent additional bronchial artery embolization for the control of reccurrent hemoptysis to find the clauses of rebleeding. Results : 1) Underlying causes of hemoptysis were pulmonary tuberculosis(n=35), bronchiectasis(n=5), aspergilloma(n=2), lung cancer(n=2), pulmonary A-V malformation(n=1), and unknown cases(n=2). 2) Overal immediate success rate was 94%(n=44), an6 recurrence rate was 40%(n=19). 3) The prognostic factors such as bilaterality, systemic-pulmonary artery shunt, multiple feeding arteries and degree of neovascularity were not statistically correlated with rebleeding tendency (p value>0.05). 4) At additional bronchial artery embolization, Revealed recannalization of previous embolized arteries were 14/18cases(78%) and the presence of new deeding arteries was 8/18cases(44%). 5) The complications(31cases, 66%) such as fever, chest pain, cough, voiding difficulty, paralytic ileus, motor and sensory change of lower extremity, atelectasis and splenic infarction were occured. Conclusion : Recannalization of previous embolized arteries is the major cause of recurrence after bronchial artery embolization. Despite high recurrence rate of hemoptysis, bronchial artery embolization for management of massive hemoptysis is a effective and saute procedure in immediate bleeding control.

• Journal of Chest Surgery
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• v.32 no.1
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• pp.58-61
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• 1999

Cor triatriatum is a rare anomaly in old age. This is a case report of a 66 year-old man who had been preoperatively diagnosed as coronary artery disease and cor triatriatum. The operative findings revealed that the left atrium had an intra-atrial septum with one small opening 10mm in diameter, the upper compartment received both pulmonary veins, and there were no other anomalies like anormalous pulmonary venous connection or atrial septal defect. The patient successfully underwent open heart surgery ; the anomalous septum was resected, the mitral valve was reconstructed using French technique with Carpentier-Edwards ring, and coronary artery bypass grafting was performed.

• Tuberculosis and Respiratory Diseases
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• v.56 no.6
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• pp.677-682
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• 2004

Takayasu's arteritis is a chronic inflammatory disease that primarily affects large vessels, such as the aorta and its main branches. Pulmonary artery is often involved in Takayasu's arteritis, but only a few cases have been reported in which pulmonary artery involvement occurred as the initial clinical manifestation. We report one patient who was referred to our institution with the provisional diagnosis of chronic thromboembolic pulmonary hypertension and subsequently diagnosed with Takayasu's arteritis involving the pulmonary artery.

• Journal of Chest Surgery
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• v.23 no.1
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• pp.158-161
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• 1990

A congenital coronary artery fistula is an uncommon anomaly which has a direct communication between a coronary artery and the lumen of any one of the four cardiac chambers, or the coronary sinus, or its tributary veins or the superior vena cava. The right coronary artery is involved most frequently, and the abnormal communication in most often is to the right ventricle followed in incidence by drainage into the right atrium and the pulmonary artery. Recently. we experienced a case of congenital coronary artery fistula associated with valvular heart disease. The fistulous communication was noted between the left circumflex artery and the left atrial appendage. Under the cardiopulmonary bypass, the internal obliteration of the left atrial appendage, mitral valve replacement, and aortic valve exploration were accomplished. Postoperative hospital course was uneventful and the patient was discharged without any problems.

• Journal of Chest Surgery
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• v.26 no.9
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• pp.710-713
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• 1993

Congenital coronary fistula is a rare condition, and with widespread use of cardiac catheterization, angiography and selective coronary arteriography are being recognized with increasing frequency. Fistula originating from the right coronary artery are more common than those from the left coronary artery. The fistula empties into the right side of the heart in 90% of the cases with the right ventricle being the most common recipient chamber, followed by the right atrium and the pulmonary artery. We report a case of congenital coronary artery fistula of the right coronary artery to the left ventricle with significant shunt in a 20 - year old female. It was detected by transthoracic and transesophageal echocardiography and confirmed by cardiac catheterization and coronary angiography. The fistula opening was closed with 6-0 Prolene continuously under cardiopulmonary bypass and moderate hypothermia [ 28 oC ]. Postoperative course was uneventful and the patient was discharged without specific problem.

• Journal of Chest Surgery
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• v.23 no.4
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• pp.758-763
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• 1990

A congenital fistulous communication between the coronary artery and the cardiac chamber or the pulmonary artery is a rare condition, but increasing cases with this anomaly are being recognized with wide spread use of cardiac catheterization and coronary arteriography. Recently we experienced one case of right coronary artery fistula which was associated with atrial septal defect. The patient was a 24 year old female who was admitted because of cardiac murmur, palpitation and dyspnea on exertion after pregnancy. Cardiac catheterization and selective coronary arteriography revealed that a fistulous communication, forming a large aneurysm, was noted from the right coronary artery emptied into the right ventricle. On the operation field, the right coronary artery was curved and markedly dilated from the aorta to the middle segment at acute margin of the right ventricle. The egg-sized aneurysm of dilated right coronary artery was noticed on right ventricle. The aneurysm was incised longitudinally and both the proximal opening and the termination site of the fistula were closed directly with aneurysmectomy. The right atrium was also opened to evaluate the fistulous termination site and repaired only small interatrial septal defect. Postoperative course was uneventful and she was discharged without problems

• Journal of Chest Surgery
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• v.20 no.4
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• pp.688-694
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• 1987

At the Dept. of Thoracic and Cardiovascular Surgery of Pusan National University Hospital, postoperative cardiac catheterizations were performed in 12 patients of ventricular septal defect with severe pulmonary hypertension [Pp/Ps>0.75], who were operated during the period from July 1981 to Dec. 1986. The mean age of the patients preoperatively was 12.4 [range: 4-18] year-old and the mean follow-up duration was 25.8 [range: 8-53] month per patient. In comparison with the preoperative data, the systolic pulmonary artery pressure [SPAP] was decreased from 103.6*18.4 to 70.4*35.9 mmHg [p<0.01] and the Pp/Ps was decreased from 0.89*0.10 to 0.58*0.27 [p<0.01]. But the Rp/Rs and Rp were not meaningfully changed, from 0.31*0.16 and 7.6*0.4 unit to 0.41*0.32 and 8.0*6.6 unit, respectively. The preoperative Qp/Qs was bellow 2.0[mean: 1.6] in 3 out of 4 cases whose postoperative Rp/Rs and Rp were above 0.75 and 15 unit, respectively. On the contrary, the preoperative Qp/Qs was above 2.0 [mean: 3.5] in all of the 8 cases, whose postoperative Rp/Rs and Rp were below 0.50 and 10 unit, respectively.